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Effects of peridialytic oral supplements on nutritional status and quality of life in chronic hemodialysis patients.

Abstract

OBJECTIVE

Our objective was to determine the effects of peridialytic oral supplements on nutritional markers and quality of life (QOL) in patients receiving maintenance hemodialysis.

DESIGN

This trial was open, prospective, nonrandomized, and comparative.

SETTING

This study was performed at an outpatient hemodialysis unit in a teaching hospital.

PATIENTS

This study included 88 adults with chronic kidney disease at stage 5.

INTERVENTION

This study involved directly observed nutrition therapy with >or=1 can of enteral nutrition (Nepro) with each hemodialysis session thrice weekly for 3 months, or standard care.

MAIN OUTCOME MEASURE

Changes in biochemical markers of nutritional status and QOL, as measured by the Kidney Disease Quality of Life-Short Form, were determined.

RESULTS

Peridialytic oral nutrition resulted in a significant difference between the nutrition and comparison groups in serum albumin change over time (P = .03; repeated-measures analysis of variance with covariates). Mean (+/-SD) serum albumin concentration did not differ between baseline and month 3 in the nutrition group (3.68 +/- 0.33 g/dL vs. 3.75 +/- 0.40 g/dL; P = .12), but in the comparison group, serum albumin levels declined significantly (3.93 +/- 0.34 g/dL at baseline versus 3.81 +/- 0.37 g/dL at month 3; P = .04). The "role-physical" domain score of the Kidney Disease Quality of Life-Short Form significantly changed over time in the nutrition group versus the comparison group (P = .02; repeated-measures analysis of variance with covariates). Nepro was well-tolerated, and greater than 80% of the prescribed therapy was consumed.

CONCLUSION

Oral nutrition, as part of structured, directly observed peridialytic therapy in chronic hemodialysis patients, was well-accepted, and resulted in the maintenance of serum albumin levels and QOL with respect to impact of physical health on daily activities. These findings need to be confirmed in a randomized, controlled trial.

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  • Authors+Show Affiliations

    ,

    Clinical Development Organization, Eli Lilly and Co, Indianapolis, Indiana.

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    Source

    MeSH

    Analysis of Variance
    Biomarkers
    Enteral Nutrition
    Female
    Humans
    Kidney Failure, Chronic
    Male
    Middle Aged
    Nutrition Disorders
    Nutritional Status
    Prospective Studies
    Quality of Life
    Renal Dialysis
    Serum Albumin
    Surveys and Questionnaires

    Pub Type(s)

    Clinical Trial
    Comparative Study
    Journal Article

    Language

    eng

    PubMed ID

    19218041

    Citation

    Scott, Meri Kay, et al. "Effects of Peridialytic Oral Supplements On Nutritional Status and Quality of Life in Chronic Hemodialysis Patients." Journal of Renal Nutrition : the Official Journal of the Council On Renal Nutrition of the National Kidney Foundation, vol. 19, no. 2, 2009, pp. 145-52.
    Scott MK, Shah NA, Vilay AM, et al. Effects of peridialytic oral supplements on nutritional status and quality of life in chronic hemodialysis patients. J Ren Nutr. 2009;19(2):145-52.
    Scott, M. K., Shah, N. A., Vilay, A. M., Thomas, J., Kraus, M. A., & Mueller, B. A. (2009). Effects of peridialytic oral supplements on nutritional status and quality of life in chronic hemodialysis patients. Journal of Renal Nutrition : the Official Journal of the Council On Renal Nutrition of the National Kidney Foundation, 19(2), pp. 145-52. doi:10.1053/j.jrn.2008.08.004.
    Scott MK, et al. Effects of Peridialytic Oral Supplements On Nutritional Status and Quality of Life in Chronic Hemodialysis Patients. J Ren Nutr. 2009;19(2):145-52. PubMed PMID: 19218041.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Effects of peridialytic oral supplements on nutritional status and quality of life in chronic hemodialysis patients. AU - Scott,Meri Kay, AU - Shah,Niyati A, AU - Vilay,A Mary, AU - Thomas,Joseph,3rd AU - Kraus,Michael A, AU - Mueller,Bruce A, PY - 2008/01/21/received PY - 2009/2/17/entrez PY - 2009/2/17/pubmed PY - 2009/6/2/medline SP - 145 EP - 52 JF - Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation JO - J Ren Nutr VL - 19 IS - 2 N2 - OBJECTIVE: Our objective was to determine the effects of peridialytic oral supplements on nutritional markers and quality of life (QOL) in patients receiving maintenance hemodialysis. DESIGN: This trial was open, prospective, nonrandomized, and comparative. SETTING: This study was performed at an outpatient hemodialysis unit in a teaching hospital. PATIENTS: This study included 88 adults with chronic kidney disease at stage 5. INTERVENTION: This study involved directly observed nutrition therapy with >or=1 can of enteral nutrition (Nepro) with each hemodialysis session thrice weekly for 3 months, or standard care. MAIN OUTCOME MEASURE: Changes in biochemical markers of nutritional status and QOL, as measured by the Kidney Disease Quality of Life-Short Form, were determined. RESULTS: Peridialytic oral nutrition resulted in a significant difference between the nutrition and comparison groups in serum albumin change over time (P = .03; repeated-measures analysis of variance with covariates). Mean (+/-SD) serum albumin concentration did not differ between baseline and month 3 in the nutrition group (3.68 +/- 0.33 g/dL vs. 3.75 +/- 0.40 g/dL; P = .12), but in the comparison group, serum albumin levels declined significantly (3.93 +/- 0.34 g/dL at baseline versus 3.81 +/- 0.37 g/dL at month 3; P = .04). The "role-physical" domain score of the Kidney Disease Quality of Life-Short Form significantly changed over time in the nutrition group versus the comparison group (P = .02; repeated-measures analysis of variance with covariates). Nepro was well-tolerated, and greater than 80% of the prescribed therapy was consumed. CONCLUSION: Oral nutrition, as part of structured, directly observed peridialytic therapy in chronic hemodialysis patients, was well-accepted, and resulted in the maintenance of serum albumin levels and QOL with respect to impact of physical health on daily activities. These findings need to be confirmed in a randomized, controlled trial. SN - 1532-8503 UR - https://www.unboundmedicine.com/medline/citation/19218041/Effects_of_peridialytic_oral_supplements_on_nutritional_status_and_quality_of_life_in_chronic_hemodialysis_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1051-2276(08)00390-7 DB - PRIME DP - Unbound Medicine ER -